[Agreement of panoramic radiography and doppler sonography in detection of carotid artery calcification]

According to some studies, diagnosis of carotid artery calcification in panoramic radiography could be a good marker and an aid for the prediction and prevention of cerebrovascular and cardiovascular accidents. Doppler sonography is an important diagnostic method for the recognition of calcified atheroma and carotid artery stenosis, With respect to the importance of the recognition of calcified atheroma and vast usage of panoramic radiography in dental treatments, the purpose of this study was to evaluate the degree of agreement between panoramic radiography and Doppler sonography in the diagnosis of calcified carotid artery. In this descriptive-analytic study, panoramic radiographs were taken from 35 nephrologic and neurologic patients with carotid Doppler sonography, in order to evaluate calcified carotid atheroma. Panoramic radiographs were designed in a form that, the most of cervical vertebrae height to the level of the 4[th] and 5[th] intervertebral spaces, could be seen. The data related to the presence or absence of calcified atheroma in Doppler sonography and panoramic radiography were collected by SPSS software. The degree of agreement between the two methods was evaluated by Kappa analysis. Panoramic radiograph and Doppler sonography in both male and female patients in right side showed an average to good agreement rate. Overall, this agreement in patients with cerebrovascular complications without paying any attention to the affected side was from good to average degree. The presence of linear and nodular opacities in the level of 3[rd]-4[th] or 4[th]-5[th] intervertebral spaces in panoramic radiography especially at the right side could be considered serious. If positive risk factors are also present, the patients could be referred, with great confidence and economical justification, for precise medical examinations, [Doppler Sonography]

Safety and antithrombotic effects of fixed low-dose warfarin-aspirin combination in rheumatic mitral stenosis associated with atrial fibrillation

The incidence of thromboembolic complications in cases of mitral stenosis [MS] associated with atrial fibrillation [AF] is around 20%. To prevent this complication, warfarin and aspirin is administered to keep the INR between 2 and 3. However, this treatment is associated with increased risk of hemorrhagic episodes. Fifty-five patients with both rheumatic MS and AF, were randomly divided into two groups; Twenty-five patients received 2.5-mg of warfarin and 100 mg of aspirin daily, and thirty patients served as control. The mean +/- SD INR in the treatment group [1.58 +/- 0.45] was significantly higher than that of the control group [1.175 +/- 0.21] [p < 0.001]. Twenty per cent of the control group developed thromboembolic complications. However, none of the patients in the treatment group had any thromboembolic or hemorrhagic events. No inter - or intra-patient INR variability was seen. Therefore the use of low-dose warfarin - aspirin combination for the prevention of thromboembolic complications in patients with MS associated with AF is effective and safe, and thus, is strongly suggested